General Medical And Surgical Hospital Industry

Our healthcare system is in a state of constant change. Just as the industry was adapting to the demands of countless healthcare reforms, the fate of regulations like the Affordable Care Act (ACA) and others like it, dangle in the wind. As the country transitions to a newly appointed administration, there is an increasing level of uncertainty among industry leaders. Federal, state, and local mandates continue to drive the need to improve the quality, costs, and outcomes of care which add to an already overburdened and burnout system. These coupled with our highly secular society who is primarily focused on the treating and curing illness through advanced technology, medications, and procedures has resulted in a

On March 23, 2010, President Barack Obama signed the Affordable Healthcare bill into law. There has been much controversy over this Affordable Healthcare Act before and since it was signed into law. It was estimated that 30 million people would sign up for the new healthcare and that the healthcare industry would need a bigger workforce. Within hospitals across the United States there is already a shortage of nursing and medical staff. What will this new law mean for hospitals in their declining health care professionals? In what other ways will this healthcare law impact hospitals across the United States? This paper will attempt to explore some of the realities and possibilities in greater depth.

In a world of budget cut and layoffs, medical corporations face new and different challenges in addition to helping and healing patients. I used to work as a medical biller in a physician’s office for five years and I experienced how difficult for the health care providers to get reimbursed. The government and the insurance companies have been limiting the budget towards the health care services. This action also affects the hospitals greatly because Centers for Medicare & Medicaid Services (CMS) and some policymakers have requested the hospitals to reduce the

As discussed previously, the Affordable Care Act of 2010 passed by the legislature, drastically changed the entire healthcare economy. In fact, ever since the ACA was passed it was required by law for hospitals to increase the amount of attention given to the individuals of the community in order to meet their needs. Also, the ACA allowed close to 10 million individuals to have health insurance through Medicaid and private health insurances, which has a high impact on all the hospitals, such as Yale New Haven. For example, since millions of Americans can now afford health insurance, there is a large influx of patients who can go to hospitals and actually afford the overall cost. The non-profit hospital of Yale New Haven is benefiting in two ways. First, they are achieving their mission by caring for the individuals of their community who now have insurance and secondly, they are being compensated in terms of revenue to improve their organization in regards to hiring the greatest physicians and having the best technology and supplies to treat their large influx of patients (Cunningham, 2015). The rise in health insurances increases the total amount of money earned by that non-profit organization and the amount of patients receiving great quality of care.

The healthcare system in America started as a predominantly volunteer system where patients were required to pay little to nothing for treatment. Since it began, the healthcare industry has seen tremendous changes that have transformed it into a business entity which has operations like financial management, strategic planning and functional specialties to keep the industry viable. The industry is one of the largest in the country employing 15 million people with a projected increase of jobs with 3 million jobs annually. As the healthcare industry continues growing, services and personnel are changing, and various dynamics are coming into play to accommodate changes (Smith, Saunders, Stuckhardt, & McGinnis, 2013).

Throughout this course I have learned about the various challenges that impede productivity and efficiency at today’s hospitals. These issues facing the modern healthcare organization come in varying forms from technological, staffing, and financial to name a few. There are no limits to what hospitals can face in these modern technologically savvy times. Below are the major issues that today’s hospitals are facing, though there are many facets to these topics it will be described as best as possible to meet overall challenges:

Healthcare in the U.S is most expensive than any other developed country. The U.S spends far more on per capita as compared to any other developed. U.S scores low on many outcome measures, inefficiencies and wastes and quality measures as compared to other countries. The Patient Protection and Affordable Care Act is developed to strengthen these failures in the health care system. The U.S healthcare is transforming care from volume based reimbursements to value based payments. The healthcare law works around providing more patient centered care and better preventive care. One of the payment reforms with Obamacare is to penalize the hospitals with high readmission rates for the three conditions – Acute Myocardial Infarction, Heart Failures and Pneumonia.

One area that has contributed to the rise of healthcare costs are the varieties of healthcare services offered to the patient. Competition between providers has caused physicians and hospitals to offer the most current healthcare technologies and modern, eye-catching settings in order to attract and retain clients (Shi & Singh, 2015). Reimbursements for costly procedures and hospital services have been compensated at a higher rate which has also supported the expansion of hospital and specialty procedure settings (Schroeder & Frist, 2013). Renovations of the physical settings and the acquisition of expensive technologies have elevated healthcare services prices to encompass the additional costs of providing high technical services and attracting clients and cause the over-utilization of expensive treatments.

The expanded health insurance coverage via the Affordable Care act is having a major effect on managed care hospitals in many avenues. These effects are impacted via the increase in demand for care, the increase of patient revenues, as well as a lower uncompensated care especially for the uninsured. Not surprisingly, the constraints as well as the controls that are being imposed by the managed care have lead to an outrage by the doctors and their patients. Managed care in the United States finds itself under attack from every side. As far as the managed care organizations are concerned, administrators are unease regarding the profitability or the surplus for reinvestment and even the consumers are also worried about the possible closure of hospitals (Goodson, 2010). Managed Care Organizations have been forced to reduce hospital utilization even though there have also been a few facility closures.

The U.S government spends about 17% of GDP on healthcare industry which is enormously high as compared to any other industrialized nation. President Obama signed the comprehensive healthcare reform – Patient Protection and Affordable Care Act on March 23, 2010. The law worked on the principles of triple aim to reduce healthcare cost, improve quality and access for the U.S citizens. One of the fundamental component of Affordable Care Act that will affect the caregiving to the U.S citizens is payment cuts to the hospitals if they do not provide quality care to their patients. The reason behind these payment cuts is because Part A Medicare Trust may go bankrupt by 2017. Hence, it is necessary to bring the cost of healthcare under control along with providing quality care to the patients. In order to contain cost, ACA proposed Medicare Readmission Program. Effective October 1, 2012 Medicare will reduce payments to the hospitals that will have higher percentage than the specified amount of preventable readmission rates. Effective fiscal year 2015, Medicare will penalize the hospitals by 1 % that will show higher number of hospital acquired infections (KFF, 2013). CMS has reported that approximated one out of every 5 Medicare patients are admitted back to the hospital within 30 days of their prior inpatient stay. Readmission rates are generally high for hospital that serve more vulnerable population like safety net hospitals. The high readmissions are caused by a

In recent years, the healthcare industry has seen a significant decline in the quality of patient care it provides. This has been the result of reduced staffing levels, overworked nurses, and an extremely high nurse to patient ratio. The importance of nurse staffing in hospital settings is an issue of great controversy. Too much staff results in costs that are too great for the facility to bear, but too little staffing results in patient care that is greatly hindered. Moreover, the shaky economy has led to widespread budget cuts; this, combined with the financial pressures associated with Medicare and private insurance companies have forced facilities to make due with fewer

The cost of the health care industry has always been rising since the early 1980s. It has been a growing concern in both the industry and society. Massachusetts General Hospital (MGH) is no exception. Even though the average length of stay (LOS) for the patients in MGH has been declining (Exhibit 10), it is still the highest compared to their competitors (Exhibit 6). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital. MGH lacks communication and coordination between the facilities.

Providing the right care, to the right patient, at the right time is not only the definition of providing quality healthcare, but also the key to the long-run viability of our healthcare system. However, our hospital delivery system is often unable to match the supply of hospital services with the demand for that care. Intense, inherent demand variability renders this synchronization almost impossible to maintain for any significant period of time. The mismatch between patients and providers has been shown to lead to significant adverse effects: demand variability has been suggested as a main driver for increasing healthcare delivery costs (Litvak E and Buerhaus P, et al. 2005), unexpected surges in admission rates have been linked to increased

The healthcare system has seen significant change over the past decade. This is due to improved technology, healthcare reform, and the economic crisis (Hendren, 2010). With the changes that are occurring,

The problem at Memorial Hospital is the focus on costs instead of health care. When a health care provider does not take the primary business as the core value of the operation and make strategic and tactical decisions based primary on costs, it decreases the consumers’ (patients) satisfaction in long run. As consumers reduce or stop purchasing goods and services from the hospital, hospital may make more cost oriented decisions and falls into a negative cycle. Eventually the hospital may face the fate of loosing business to competitors and the possibility of closing the door.